[Meniere's disease: diagnosis and new treatment perspectives].

Ménière's disease is characterized by attacks of vertigo and by sensorineural hearing loss, tinnitus, and ear fullness; these cochlear symptoms are unilateral in the majority of cases. Medical treatment tends to control vertigo and to cure the possible causes of endolymphatic hydrops (autoimmune disease, syphilis, metabolic and endocrine derangements, etc). In case of failure of medical treatment, surgery is considered. Endolymphatic mastoid shunt is indicated when hearing is normal or fluctuating. In all other cases, vestibular neurectomy or chemical vestibular labyrinthectomy, by means of intratympanic low concentration gentamicin (20 mg/mL), are indicated. Total or substantial regression of vertigo, at 2 years follow up, occurs in 65% of cases after endolymphatic-mastoid shunt, and in > 90% after vestibular neurectomy or chemical vestibular labyrinthectomy.